| NPI | 1730707944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.026649) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN25507) |
| 122300000X Dentist (Licence: FL DRPM2193) | |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2023-02-21 |